An approach to keratinization disorders

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Keratinization is the process by which epithelial cells in the skin differentiate progressively from basal cells attached to the basement membrane into fully keratinized cells that are exfoliated from the skin surface. Keratinization is a complex process that is genetically programmed and regulated by the interactions of a myriad of intrinsic and extrinsic factors. Cornification of the skin also involves the formation of a lipid-rich intercellular matrix that serves as a mortar between the stacks of anucleate, flattened keratinocytes in the stratum corneum. This lipid matrix serves as a permeability barrier for the skin, regulates desquamation and has antimicrobial activity. The chapter looks at: Differential diagnosis; Clinical approach; and Treatment.

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6.1 Seborrhoea sicca in a hypothyroid mixed-breed dog. Numerous scales have accumulated in the hair coat of this dog with seborrhoea sicca secondary to hypothyroidism. Greasy accumulations on the ventral neck of a dog with seborrhoea oleosa. Seborrhoeic dermatitis in a mixed-breed dog with pemphigus foliaceus. Follicular casts on the back of a Standard Poodle with sebaceous adenitis.
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6.3 Lethal acrodermatitis. Bull Terrier puppies. Splayed toes of an affected Bull Terrier puppy.
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6.4 Ear margin seborrhoea.
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6.5 West Highland White Terrier with epidermal dysplasia and dermatitis.
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6.6 Non-epidermolytic ichthyosis. Large scales on the side of a Golden Retriever. Tightly adherent scales on the ventral abdomen and inguinal region of a 10-week-old American Bulldog.
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6.7 Alaskan Malamute with zinc-responsive dermatitis syndrome I.
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6.8 Nasal hyperkeratosis in a Boston Terrier.
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6.9 Sebaceous adenitis. Beagle. Note the polycyclic pattern of alopecia on the ear pinna. Vizsla. Note the polycyclic pattern of alopecia.
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6.10 Feline acne. Note the dark keratinous debris and comedones on the chin.
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6.11 Idiopathic facial dermatitis in a 1-year-old Persian.

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